CN111065310A

CN111065310A - Medical device with camera and placement method

Info

Publication number: CN111065310A
Application number: CN201880056033.4A
Authority: CN
Inventors: 罗伯特·莫尔纳
Original assignee: WM&DG Inc
Current assignee: WM&DG Inc
Priority date: 2017-08-31
Filing date: 2018-08-30
Publication date: 2020-04-24
Also published as: EP3675705A4; US11051682B2; EP3675705A1; US20190059710A1; US20210307598A1; WO2019046509A1; CA3073511A1; AU2018324046A1

Abstract

The present invention provides a medical device comprising a camera in combination with an attachment device selected from an endotracheal tube, an oral airway, an supraglottic airway, a tracheostomy tube, an inhalation tube, a tubeless intubation device, a tool tube, and/or a stylet. The present invention also provides a method for rapid and accurate placement of a medical device guided by a probe and continuous real-time monitoring (including remote monitoring) of the patient after placement.

Description

Medical device with camera and placement method

Cross Reference to Related Applications

This application claims priority to U.S. patent application 15/692, 416 filed on 2017, 8, 31, the entire disclosure of which is incorporated herein by reference.

Technical Field

The present invention provides a set of disposable medical devices, including various intubation devices, in combination with a disposable camera that provides continuous visualization during and after placement into a patient. Sound devices such as microphones can be incorporated into many devices and provide continuous monitoring of patient breathing and heart sounds. The continuous visualization and sound monitoring of the patient are real-time, and remote monitoring can be realized. Methods for rapid and accurate placement of a medical device within a patient are also provided.

Background

Various devices may be used to stabilize the patient for his convenience in breathing, feeding and drug delivery. Such devices are used in patients who are post-traumatic in surgery for certain conditions, including spinal cord injury, and in patients with certain diseases, including advanced alzheimer's disease. These devices include endotracheal tubes, airway devices, feeding tubes, oral airways, nasal cannulas, and the like.

The process of placing an expiratory tube in a patient is called intubation. Devices such as laryngoscopes, video laryngoscopes, fibre-optic microscopes and other proprietary video scopes have been developed. These devices provide accuracy for initial placement, but do not provide continuous visualization or mobility of the images after the medical device is placed within the patient. Newer devices, such as VivAsight SL or DL endotracheal tubes, provide continuous visualization, but are costly because they rely on a single use of a disposable camera, and they are not transferable from one medical device to another. The TotAlTrAck VLM supraglottic airway has a proprietary reusable camera, is only suitable for one of its devices, and cannot be transferred to other medical devices.

Thus, there remains a need for improved devices that allow qualified personnel to easily remotely monitor such equipment during and after placement to see if an adverse reaction has occurred. There remains a need to monitor patients in real time for possible adverse reactions, such as inhalation, airway secretions, apnea, etc., after the medical device has been placed in the patient.

Some medical devices providing continuous visualization are shown in US patent 9, 415, 179 and patent publications US2016-0038008, US2016-0038014 and US 2016-0262603. In these devices, the camera is placed within a camera tube, which is a separate lumen sealed at the distal end. This may prevent the camera from coming into contact with the patient's body and allow the camera to be reused in a variety of devices and between different patients without the need for sterilization. While these devices may include a disposable camera, these devices still include a separate camera tube sealed at the distal end.

Disclosure of Invention

The present invention provides a medical device with a disposable camera without a separate sealed camera tube. The camera may be transferred between various devices. Each device may provide continuous visualization during intubation, extubation, and positioning within the patient. The device does not include a camera tube sealed at the distal end so that the camera head can be transferred between the various devices.

The device comprises a medical intubation device, including: a camera head, which is combined with an attachment device comprising an endotracheal tube, an oral airway tube, a tracheostomy tube, an inhalation tube, a tubeless intubation device, an supraglottic oral airway tube, a truncated supraglottic oral airway tube, a tool tube, a trocar, a vent cover, medical examination gloves and/or a stylet. The camera head has a distal end and a proximal end, and the attachment device also has a distal end and a proximal end. The camera distal end is proximate to the attachment distal end. In some devices, the camera is mounted on a tube. The camera is coupled to the attachment by placing the attachment in the tube. The position of the camera on the supplemental medical device may be adjusted by sliding the tube along the proximal-distal shaft of the supplemental device.

In some arrangements, the camera is mounted on at least one ring, which optionally includes a snap ring. The attachment device includes a tube. The camera head is coupled to the attachment device by the ring secured around the tube.

In some devices, the attachment device includes a cuff. The camera is coupled to the attachment by being placed under the cuff such that a distal end of the camera is distal to the cuff.

In some devices, the camera is mounted on the tool tube and/or the stylet. The tool tube may be a slit-wall tube and a probe may be inserted into the slit-wall tube.

In some devices, the camera is mounted on the tool tube and/or the stylet, and a probe is placed in the tool tube. The stylet has a proximal end and a distal end, and the distal end of the stylet extends from the distal end of the tool tube, and the stylet extends from the distal end to the distal end of the camera head.

The attachment means may be an endotracheal tube and an inflatable cuff wrapped around the endotracheal tube adjacent the distal end thereof, the camera head being sealed along the exterior of the proximal-distal shaft of the endotracheal tube.

The attachment may be an endotracheal tube with an inflatable cuff wrapped around the endotracheal tube and the camera head is proximal to the distal end of the endotracheal tube, and the distal end of the camera head collects images of the distal end of the cuff.

The attachment may be an endotracheal tube with an inflatable cuff wrapped around the endotracheal tube and the camera head located near the distal end of the endotracheal tube, and the endotracheal tube has a sleeve near the proximal end of the endotracheal tube and the camera head is inserted into the sleeve.

The add-on device may be a tracheostomy tube comprising a tube with a flap and an inflatable cuff wrapped around the tube near its distal end, and the camera is coupled to the exterior of the tube by insertion into the opening of the flap and placement under the inflatable cuff.

The add-on device may be an endotracheal tube externally coupled to a tool tube, the tool tube may optionally include a cap, and the endotracheal tube may be secured to the endotracheal tube with at least one ring, the camera head slides into the tool tube, and at least one of the following tools may be selected for insertion into the tool tube: biopsy forceps, esophageal stethoscopes, sleeves, suction tubes, gastric tubes, stylets, and/or probes.

The add-on device may be an endotracheal tube wherein the endotracheal tube is externally coupled to a tool tube, the tool tube may optionally include a cover, and the endotracheal tube is secured to the endotracheal tube with a cuff that wraps around the tool tube and the endotracheal tube, the camera head slides into the tool tube, and at least one of the following tools may be selected for insertion into the tool tube: biopsy forceps, esophageal stethoscopes, sleeves, suction tubes, gastric tubes, stylets, and/or probes.

The attachment is an oral airway tube comprising a curved tube with a proximal end and a distal end, the tube having a lumen and a web at the proximal end of the curved tube, and a camera coupled to the tube by insertion through an opening in the web and then through an opening in the wall of the curved tube, the distal end of the camera being inside the lumen and adjacent to the distal end of the curved tube.

The attachment may be an oral airway tube comprising a hollow curved tube with a proximal end and a distal end, the hollow tube having an interior and a membrane at the proximal end of the curved tube, and the camera head being attached to the tube by insertion through an opening in the membrane and placement along the exterior of the hollow curved tube, the attachment further comprising a further hollow tube aligned with the hollow curved tube, a balloon being wrapped around the hollow curved tube, the further hollow tube and the camera head.

The attachment means may be an oral airway device comprising a two-part tube formed from an outer cylindrical wall and an inner cylindrical wall, at least part of the inner cylindrical wall being insertable into the outer cylindrical wall, the inner cylindrical wall being extendable, the camera being insertable into the two-part tube through an opening located near the proximal end of the tube so as to be coupled to the oral airway device, and optionally a probe.

The attachment means may be an oral airway device comprising two hollow tubes, a first hollow tube and a second hollow tube, the first hollow tube being partially inserted into the second hollow tube, the first hollow tube being longer in length than the second hollow tube, the first hollow tube being insertable into and removable from the second hollow tube, the first hollow tube having a tapered tab at a distal end, the second hollow tube having a sheet at a proximal end, the camera being inserted into the sheet through an opening in the sheet and being engageable with the attachment means by placement along the exterior of the second hollow tube, the oral airway device comprising a tool lumen.

The attachment means may be an oral airway device comprising a curved tube with a central lumen and a flap at the proximal end of the curved tube, the cuff wrapped around the curved tube, a handle mounted on the cuff which can be moved by the handle from the proximal end of the curved tube to the distal end of the curved tube, the camera inserted through an opening in the flap and engaged with the attachment means by being placed along the exterior of the second hollow tube, and the cuff wrapped around the camera so that the camera distal end is distal to the cuff.

The attachment means may be an oral airway device comprising a curved tube body having a central lumen into which two tubes are inserted, a first hollow tube and a second hollow tube with a slit wall, the first and second hollow tubes each being mounted to the wall of the oral airway device with the distal end of the first and second hollow tubes near the distal end of the curved tube body, a camera may be inserted in the first hollow tube, and a stylet and/or a medical instrument may be inserted in the second hollow tube. The cuff is wrapped around the curved tube body near the distal end of the curved tube body.

The additional device is a supraglottic oral cavity air duct which comprises a tube body with a central tube cavity, a soft cuff is wrapped on the periphery of the far end of the tube body, the wall of the tube body comprises a first tube cavity and a second tube cavity with a slit, a camera can be inserted into the first tube cavity, a probe can be inserted into the second tube cavity, and the slit is connected with the second tube cavity and the central tube cavity of the tube body. In some embodiments, the tube is severed and the device includes a handle with a stent, a first hollow tube connected to the first lumen, and a second hollow tube with a slit wall connecting the second lumen to the slit.

A method of intubating a patient is also provided, wherein any medical device is inserted by guiding the insert with a stylet under continuous visualization by the camera.

Drawings

Fig. 1A and 1B show two embodiments of an endotracheal device equipped with a camera. Figure 1A is an embodiment with a camera located proximal to the cuff. Fig. 1B is an embodiment with a camera located distal to the cuff.

Figures 2A and 2B show side views of alternative embodiments of endotracheal devices equipped with a camera head delivered through a sliding sleeve. The camera can slide along the endotracheal tube.

Figure 3A shows an endotracheal device equipped with a camera containing a ring. Fig. 3B is a side view of a camera head comprising two rings. Fig. 3C is a cross-sectional view through the camera head showing the adjustable slip ring with a snap ring mounted on the camera head.

Fig. 4A shows an endotracheal device in which an endotracheal tube is inserted into a tube attached to a camera head. Fig. 4B shows the camera attached to the tube. Fig. 4C is a cross-sectional view of the camera attached to the tube of fig. 4B.

Fig. 5A shows a tracheostomy tube externally equipped with a camera. Fig. 5B shows a tracheostomy tube equipped with a camera placed inside the tracheostomy tube.

Fig. 6A shows a suction tube equipped with a camera inside. Figure 6B shows the suction catheter externally equipped with a camera.

Fig. 7A shows a tubeless intubation device equipped with a camera. Figure 7B shows the combination of the tubeless intubation device of figure 7A with an endotracheal tube. Fig. 7C illustrates loading of the supraglottic airway with glottis onto the tubeless intubation device of fig. 7A. Fig. 7D illustrates the assembly of the supraglottic airway device of fig. 7C with the tubeless intubation device of fig. 7A.

Figure 8 shows a tool tube and camera head coupled to an endotracheal tube through a ring.

Fig. 9A shows a camera and tool tube assembly, further assembled with an endotracheal tube. Fig. 9B illustrates various medical devices inserted into the tool tube of fig. 9A.

Fig. 10A shows an oral airway device equipped with a camera inserted through a channel. Fig. 10B shows insertion of an endotracheal tube into the oral airway device of fig. 10A. Fig. 10C shows another embodiment with an alternative location of the channels on the oral airway device body. Fig. 10D is another embodiment of an oral airway device including two balloons and a camera. Fig. 10E shows an oral airway device in combination with a probe. Fig. 10F shows the oral airway device of fig. 10E assembled with an endotracheal tube.

Fig. 11A shows an adjustable length oral airway device. Figure 11B shows the device of figure 11A assembled with an endotracheal tube. Fig. 11C is an enlarged view of a distal portion of the device of fig. 11A with a camera head secured in the oral airway tube. FIG. 11D is an enlarged view of a distal portion of the device of FIG. 11A, the device having a camera of its own wherein the camera is movable and capable of sliding in and out of the oral airway tube. Fig. 11E is another embodiment of an adjustable length oral airway device.

Fig. 12A is an embodiment of a camera head assembled with a stylet. In the embodiment of fig. 12B, the stylet is curved.

Figure 13 shows an oral airway device comprising two tubes with a probe and a camera.

Fig. 14A shows an oral airway device with a cuff operated by a handle. Figure 14B shows the cuff of the device in figure 14A moving distally.

Figure 15A shows an oral airway device equipped with a camera head and a slit-wall tube, both of which are located inside the oral airway device. Fig. 15B shows another embodiment of an oral airway device equipped with a camera and a slit-wall tube.

Figure 16A shows a supraglottic airway device with a camera and a slit-wall tube. Fig. 16B shows positioning of an endotracheal tube in the supraglottic airway device of fig. 16A.

Figure 17A shows a truncated supraglottic airway device with a camera and a slit-wall tube. Fig. 17B shows positioning of an endotracheal tube in the supraglottic airway device of fig. 17A.

FIG. 18A shows a medical examination glove equipped with a camera. FIG. 18B is an alternative embodiment of a medical examination glove equipped with a camera.

Fig. 19A shows a camera head equipped with two stands. Fig. 19B shows the assembly of the camera head of fig. 19A with an endotracheal tube.

Figure 20 shows a vented cap fitted with a camera and its use in a supraglottic airway device or endotracheal tube.

FIG. 21 shows a laparoscopic trocar equipped with a camera.

Detailed Description

The present invention provides a medical device equipped with a camera for intubation, ventilation, feeding and monitoring of a patient. The present invention also provides methods for rapid and accurate placement of a medical device within a patient and remote continuous real-time monitoring of the patient after placement.

The present invention provides a set of medical devices equipped with a disposable camera that can be transferred between medical devices as needed. During normal and abnormal ventilation, these devices can provide real-time continuous visualization of the patient of any of the following: nasopharynx, pharynx/hypopharynx, supraglottic structures, airway, internal organ body structures, vocal cords. These devices can also detect abnormal body structures and abnormal vocal cord movements.

The camera in the present device includes a digital camera coupled to a power line. The digital camera may include a CCD (charge coupled device) and/or CMOS (complementary metal oxide semiconductor) sensor. The captured image may be transmitted by wire or wirelessly.

Referring to fig. 1A, the present embodiment provides an endotracheal device, generally 10. The endotracheal device 10 includes an endotracheal tube 12 having a distal end 12A and a proximal end 12B. The endotracheal tube 12 includes an inflatable cuff 13 wrapped around the endotracheal tube 12 proximally of the distal end 12A. After the endotracheal tube 12 is placed in the patient, the cuff 13 can be inflated with the device 14. The endotracheal tube 12 includes a sheet 15 located near the proximal end 12B. The sheet 15 is perpendicular to the endotracheal tube 12 and prevents the endotracheal tube 12 from slipping into the patient after the device 10 is placed in the patient.

The camera head 16 seals externally along the proximal-distal (12B-12A) axis of the endotracheal tube 12. The diameter of the camera 16 is not limited by the diameter of the endotracheal tube 12. The diameter of the camera 16 may be greater or less than the diameter of the endotracheal tube 12. This may be particularly beneficial for pediatric patients and patients with anatomical abnormalities.

In the embodiment of fig. 1A, the camera 16 is located near the cuff 13. The camera 16 may include a battery (not shown), and/or wires 18 for connection to external devices, such as a computer and monitor (not shown). The camera 16 may also include means for wirelessly transmitting images. The camera 16 may also include a light source that may be built into the camera 16.

In at least some applications, camera 16 is a digital camera equipped with a chip, and camera 16 continuously captures and transmits images. The camera 16 may be wirelessly or hardwired connected to a computer network (not shown) that collects and analyzes images obtained by the camera 16. This arrangement allows for remote, continuous, real-time monitoring of the endotracheal device 10 during and after patient placement. Accordingly, accurate and rapid placement of the endotracheal device 10 can be achieved. Furthermore, because the camera 16 continues to acquire images after the endotracheal device 10 is placed in the patient, adverse reactions of the patient, such as bleeding, airway obstruction, dislodgement, or malfunctions of the endotracheal device 10, among other reactions, may be monitored in real time. As long as the endotracheal device 10 remains within the patient, it can continue to transmit images and information.

The endotracheal device 10 may also be equipped with a sound monitoring device (not shown), such as a microphone, which may monitor heart beat and breathing tones, and may be connected by wired or wireless connections to a remote device that collects and monitors vital signals of the patient.

In the embodiment of fig. 1A, a camera 16 is placed proximal to the cuff 13 and outside the endotracheal tube 12. It is to be understood that the endotracheal device 10 can be constructed of any endotracheal tube 12, including single lumen and dual lumen tubes. The endotracheal device 10 may be used with pediatric or adult patients. The endotracheal device 10 can be made in a variety of sizes.

Fig. 1B is another embodiment of an endotracheal device 20, the endotracheal device 20 including an endotracheal tube 12 having a cuff 13 and other elements shown in connection with fig. 1A. In the embodiment of fig. 1B, camera head 16 is sealed to the exterior of endotracheal tube 12 along distal-proximal axis 12A-12B. Unlike the embodiment of fig. 1A, the camera 16 in the embodiment of fig. 1B is placed below the cuff 13, and it collects images from the far side of the cuff 13. It should be understood that the endotracheal device 20 can be constructed with any endotracheal tube 12, including single lumen and dual lumen tubes. Endotracheal device 20 may be used with pediatric or adult patients. Endotracheal device 20 can be made in a variety of sizes.

As will be readily understood by those skilled in the art, in the embodiment of fig. 1A and 1B, the camera head 16 seals along the endotracheal tube 12. In other embodiments, the camera 16 may be coupled to the endotracheal tube 12 such that the camera 16 can slide up and down the proximal-distal shaft 12B-12A of the endotracheal tube 12.

The camera head 16 may be coupled to the endotracheal tube 12 by sealing it to the endotracheal tube 12 with an adhesive. Alternatively, the camera 16 may be attached to the endotracheal tube 12 such that the camera 16 may be detached from the endotracheal tube 12 and transferred to another medical device. Such reversible attachment may be accomplished by clamping the camera head 16 to the endotracheal tube 12 with at least one clamp or by tying the camera head 16 to the endotracheal tube 12 with a string, wire, and/or plastic and/or rubber band. Alternatively, the camera 16 may be provided with at least one ring that is slidable over the endotracheal tube 12, thereby coupling the camera 16 with the endotracheal tube 12 such that the camera 16 can slide along the endotracheal tube 12.

Fig. 2A and 2B provide another embodiment of an endotracheal tube 30 equipped with a sleeve 32. In this embodiment, the endotracheal tube 12 includes a distal end 12A and a proximal end 12B. The sleeve 32 is disposed adjacent the proximal end 12B. An inflatable cuff 13 is wrapped around the endotracheal tube 12 near the distal end 12A. The cuff 13 may be inflated with the device 14. The camera 16 is coupled to the endotracheal tube 12 by being placed through the cannula 32, along the endotracheal tube 12 and under the cuff 13. The camera 16 may be slid along the proximal-distal axis 12B-12A so that the camera 16 may be placed just at the distal end 12A of the endotracheal tube 12 as shown in fig. 2A. The camera 16 may also be slid further under the cuff 13 so that the camera 16 is placed distal to the distal end 12A of the endotracheal tube 12 and provides a distant image to the distal end 12A of the endotracheal tube 12 as shown in fig. 2B. The sleeve 32 is made of an elastic material, such as plastic or rubber. This allows the sleeve 32 to be easily folded as desired as the camera head 16 is moved distally along the endotracheal tube 12. Compare the sleeve 32 in fig. 2B, wherein the sleeve 32 in the collapsed position compares the sleeve 32 in fig. 32A to the sleeve 32 in the fully extended position.

At any time, the physician may manipulate the positioning of camera 16 by sleeve 32, including moving camera 16 proximally or distally, and/or removing camera 16 from the patient while endotracheal tube 12 remains in place in the patient. This arrangement allows the camera head 16 to be transferred between different devices. This arrangement also allows the position of the camera 16 in the patient to be adjusted according to the area to be monitored. It is understood that the device 30 may include more than one camera. In these further embodiments, another camera may provide additional images from a location proximal or distal to the camera 16.

One advantage of particular importance may be obtained by combining the camera 16 with a stylet, a flexible stylet, or any other tool that may be used to guide placement of the endotracheal tube 12 with continuous visualization from the camera 16.

Figure 3A provides another embodiment of an endotracheal device 40 where the endotracheal device 40 includes an endotracheal tube 12 having a distal end 12A and a proximal end 12B and a sheet 15 adjacent the proximal end 12B.

The endotracheal tube 12 includes an inflatable cuff 13 wrapped about the circumference of the endotracheal tube 12 proximally of the distal end 12A. After the endotracheal tube 12 is placed in the patient, the cuff 13 can be inflated with the device 14. Endotracheal device 40 includes camera 16 with electrical cord 18. In some embodiments, camera 16 may be wireless.

In the embodiment of fig. 3A, camera head 16 is externally attached to endotracheal tube 12 by

rings

44 and 42, which rings 44 and 42 wrap around endotracheal tube 12. Endotracheal tube 12 is coupled to camera head 16 by passing endotracheal tube 12 through

rings

42 and 44. It should be appreciated that the position of the camera head 16 along the distal-proximal shaft (12A-12B) of the endotracheal tube 12 is readily adjustable by adjusting the position of the

rings

42 and 44.

The camera head 16 includes two

rings

42 and 44, shown in more detail in fig. 3B, which are attached to the disposable camera head 16. The number of rings may vary between different embodiments. In various embodiments, 1 to 10 rings may be connected to camera head 16. In some embodiments, the ring may have an adjustable diameter. This can be achieved by attaching a snap ring to the ring.

In at least some embodiments, ring 46 has a snap ring 48 as shown in fig. 3C, which is a cross-sectional view of camera head 16 to which ring 46 is attached. The snap ring 48 allows the camera head 16 to be fixedly attached to tubular devices of various diameters, as the diameter of the ring 46 can be adjusted as desired. Thus, the same camera head 16 with ring 46 can be used for both pediatric endotracheal tubes and adult sized endotracheal tubes. It will be appreciated that the camera head 16 with the ring 46 may be incorporated not only with an endotracheal tube, but also with any other medical tube device. For example, camera 16 may be combined with an endotracheal tube, an oral airway tube, and any other device shown in the present disclosure.

Figure 4A provides another embodiment of an endotracheal device 50 including an endotracheal tube 12 having a distal end 12A and a proximal end 12B. Endotracheal device 50 may include a cuff 52, which cuff 52 is wrapped around endotracheal tube 12 slightly above distal end 12A, and may be inflated with device 54. The endotracheal tube 12 can also include a sheet 55 perpendicular to the tube body 12 and located near the proximal end 12B. After intubation, the sheet 55 remains outside the patient's body and prevents the endotracheal tube 12 from sliding into the patient.

As shown in fig. 4A, and in more detail in fig. 4B, camera head 16 is attached along the body of tube 56. The diameter of the catheter 56 is larger than the diameter of the endotracheal tube 12. The endotracheal tube 12 can be placed inside the tube 56 so that the camera head 16 can be placed along the endotracheal tube 12. As can be seen in fig. 4A, the catheter 56 can be slid along the endotracheal tube 12. Thus, the camera 16 may be placed closer or further from the cuff 52. Fig. 4B shows the connection of camera head 16 to tube 56. Fig. 4C is a cross-sectional view through camera head 16 and tube 56, showing camera head 16 sealed to tube 56. In fig. 4A-4C, camera 16 includes a wire 18. Other embodiments include those using wireless cameras. As can be seen in FIG. 4A, tube 56 may be rotated about tube 12, and thus, camera 16 may provide a 360 degree panoramic view of the interior region of the patient.

Further embodiments provide various tracheostomy tubes equipped with a camera. Fig. 5A shows a side view of an embodiment of a tracheostomy device 60. The device 60 includes a tube 62 with a distal end 62A and a proximal end 62B. An inflatable cuff 64 is wrapped around the tube 62 near, but not at, the distal-most end 62A. After the device 60 is placed in position in the patient, the cuff 64 may be inflated with the device 66. At the proximal end 62B, the tube 62 extends through the plastic sheet 68 such that some portion of the tube 62 is adjacent the plastic sheet 68 and will remain outside of the patient's neck after the device 60 is placed in the patient.

The plastic sheet 68 may be oval-shaped with the tubes 62 extending from the sheet 68 in the middle of the oval-shaped plastic sheet 68. The plastic sheet 68 may have two openings 69, one on each side of the sheet, so that a bandage may be used to secure the device 60 around the neck of a patient by tying the device 60 to the openings 60 around the neck of the patient.

In the embodiment of fig. 5A, camera head 16 is sealed or otherwise externally attached to tube 62. The camera head 16 is sealed or otherwise externally attached to the tube 62 along a proximal-distal (62B-62A) axis. Camera 16 is placed under cuff 64 such that cuff 64 wraps over camera 16 and camera 16 can capture images near distal end 62A.

The electrical wires 18 of the camera 16 extend through the plastic sheet 68 and remain outside the patient's neck. In other embodiments, the camera 16 may communicate wirelessly with a monitoring device. A light source may be added to the camera 16.

Fig. 5B shows another embodiment of a tracheostomy device 70. In this embodiment, the device 70 includes the same tube 62, cuff 64, sheet 68 and other components as discussed in connection with device 60.

Unlike the device 60, however, the camera 16 is placed inside the lumen 72 of the tube 62. The camera head 16 may be sealed along a proximal-distal (62B-62A) axis or otherwise attached internally to the tube 62. Because the distal end 16A of the camera head 16 is in close proximity to the distal end 62A of the tube 62, the proximal end 16B of the camera head 16 remains outside the patient. The camera 16 may be connected to a monitoring device (not shown) by a wire 18. In other embodiments, the camera 16 communicates wirelessly with the monitoring device. In some embodiments, camera 16 includes a light source.

Referring to fig. 6A, this embodiment provides a suction tube 80 with a camera. The suction tube 80 includes a hollow tube body 82 that is not flexible in the embodiment of fig. 6A. In other embodiments, the suction tube may be any suction tube known in the art. The camera head 16 is placed inside the suction tube body 82 through an opening 83, the opening 83 being in close proximity to the proximal end 82B of the suction tube 82. The camera 16 may include a wire 18. The distal end 16A of the camera head 16 is aligned with the proximal end 82A of the suction tube 82, the proximal end 16B of the camera head 16 extends out of the patient, and the proximal end 16B of the camera head 16 extends out of the patient, so that the camera head 16 can be withdrawn from the patient while the catheter body 82 remains in the patient.

Another embodiment of the suction tube 86 is shown in fig. 6B. In this embodiment, the camera head 16 is placed externally along the suction tube 82. Camera head 16 may be bonded or otherwise attached to body 82 along a proximal-distal axis (82B-82A). The distal end 16A of the camera head 16 is distal to the distal end 82A of the suction tube body 82. The proximal end 16B of the camera head 16 is near the proximal end 82B of the suction tube body 82. The device 86 may cooperate with a suction cap.

A further embodiment provides the tubeless intubation device shown in fig. 7A-7D, fig. 1 and 2, as shown in fig. 7A-7D, generally at 90. Tubeless intubation device 90 includes an ellipsoid 92 having an upper elliptical surface 93 with a lumen opening 93A on the upper elliptical surface 93 of the ellipsoid 92, as shown in FIG. 7A. As shown in fig. 7A, the upper elliptical surface 93 is connected to the lower semi-elliptical surface 94 such that the distal end 92A of the ellipsoid 92 is tapered because the lower semi-elliptical surface 94 is tapered at the distal end 92A. The ellipsoid 92 surrounds a lumen 96, which lumen 96 leads to the upper elliptical surface 93 through a lumen opening 93A. Lumen 96 is open on a proximal side of lower semi-elliptical surface 94, with tube 98 connected to lower semi-elliptical surface 94 and extending below lower semi-elliptical surface 94. The lower semi-elliptical surface 94 is also connected to a handle 100.

The handle 100 includes three sections connected together: a proximal portion 100A, an intermediate portion 100B and a distal portion 100C. The proximal end portion 100A may be made in a flat rectangular shape and has a ring holder 102 attached to the bottom surface of the proximal end portion 100A. Portion 100A is bent downwardly at an angle of approximately 90 degrees at its distal portion where it joins intermediate portion 100B. The middle portion 100B is also flat rectangular in shape and may vary in length. As can be seen in fig. 7A, the tube 98 is connected to the bottom surface of the intermediate portion 100B at a distal portion of the intermediate portion 100B. The intermediate portion 100B is connected at its distal end to the distal portion 100C. The intermediate section 100B is bent at an angle of approximately 90 degrees at the distal section and is connected to the distal section 100C. Distal portion 100C is connected by its distal end to the elliptical upper surface 93 of the ellipsoid 92.

The camera tube 16 is attached on its upper surface along the handle 100 such that the camera 16 extends from its proximal end 100A along the handle 100 and all the way into the distal end portion 100C. The camera 16 may slide along the proximal-distal axis of the handle 100. The camera 16 may further include a light source. In some embodiments, the ellipsoid 92 may include an inflatable cuff (not shown in fig. 7A) that may be inflated with the device 104.

In some embodiments, the handle 100 may be made of a flexible material. In other embodiments, the tubeless intubation device 90 may be designed without a cuff. In some embodiments, camera 16 is fixed to handle 100. In other embodiments, camera 16 may slide along the proximal-distal axis of handle 100. The distal end 16A of the camera 16 is aligned within the lumen 96 and images can be captured at this location.

The tubeless intubation device 90 may be used to intubate a patient with any size of endotracheal tube while the camera 16 is continuously visible, and may also be used for patient extubation and re-intubation. It can also be used as a supraglottic device with an endotracheal tube inflated with a cuff.

As shown in fig. 7B, the endotracheal tube 106 can be loaded onto the tubeless intubation device 90 such that the proximal end 106B of the endotracheal tube 106 is secured to the tubeless intubation device 90 by the ring holder 102. It should be understood that any endotracheal tube insertion device 90 can be inserted into a patient.

As can be seen in fig. 7B, in this embodiment, the endotracheal tube 106 is equipped with a cuff 108 near the distal end 106A of the endotracheal tube 106. The distal end 106A of the endotracheal tube 106 is then passed through the tube as shown in fig. 7B. As shown in fig. 7B, the distal end 106A of endotracheal tube 106 is caused to protrude from lumen opening 93A on the upper elliptical surface 93 of ellipsoid 92 through trachea 98 and through lumen 96. The endotracheal tube 106 is slidable along the proximal dorsal axis of the tubeless intubation device 90 such that a longer or shorter portion of the endotracheal tube 106 protrudes from the tube lumen opening 93A. The endotracheal tube cuff 108 can be inflated after it is loaded into the device 90 and secured in place with the ring holder 102.

As can be further appreciated from fig. 7B, after the endotracheal tube device 90 is delivered and assists in placing the endotracheal tube 106 within the patient under direct and continuous visualization, the endotracheal tube device 90 can be easily removed from the patient with continued visibility while the endotracheal tube 106 remains safely in place. With continuous visualization, the endotracheal tube 106 remains in place safely. Accordingly, the tubeless device 90 may be used with a standard endotracheal tube to intubate and extubate a patient. The device 90 may also be used as a supraglottic device.

As shown in the figure. As shown in fig. 7C and 7D, the tubeless intubation device 90 may be used to intubate and extubate a patient having a supraglottic airway (typically 110). The device 90 may also be used to place a laryngeal mask airway. As shown in fig. 7D, supraglottic airway 110 is secured in device 90 by ring holder 102 such that the distal end of device 110 is aligned with the distal end of device 90 while lumen 96 of device 90 is aligned with and secured to lumen 112 of device 110. Because the components of the

devices

90 and 110 are equipped with the camera 16, continuous visualization of the patient's supraglottic structures is provided during placement of the camera 16.

Figure 8 provides another embodiment of an endotracheal tube device generally 120. The device 120 includes an endotracheal tube 12 coupled to a tool tube 122. The tool tube 122 is externally coupled to the endotracheal tube 12 and held in place thereon by a ring 124. Ring 124 is attached to tool tube 122. The loop 124 allows the endotracheal tube 12 to slide very long and the tool tube 122 on the endotracheal tube 12 to be closer to or further away from the cuff 13, the cuff 13 being very close to the distal end 12A of the endotracheal tube 12. The tool tube 122 is hollow and the tool tube 122 is hollow, and medical tools and/or cameras 16 may be placed within the tool tube 122 through the proximal end 122B thereof. The camera 16 is slidable within the tool tube 122 and may protrude distally from the distal end 122A of the tool tube 122. The camera 16 may be removed from the tool tube 122 while the tool tube 122 is still in place within the patient. Tools, including but not limited to biopsy forceps 124, esophageal stethoscope 126, cuff tube 128, suction tube 130, nasogastric tube 132, stylet 134, and/or probe 136, may be inserted into tool tube 122 through proximal opening 122B.

Each ring bracket 124 is attached to the tool tube 122. The ring support 124 may be a complete ring or a half ring. The ring may also be provided with a retaining ring. It should be understood that the tool tube 122 may be attached with the ring holder 124 to any tube medical device. The tool tube 122 may then be slid proximally or distally over the tube medical device or endotracheal tube 12. The tool tube 122 may also be rotated about the tubular medical device or endotracheal tube 12. In other embodiments, the tool tube 122 may be placed internally in an endotracheal tube or supraglottic airway lumen. It should be appreciated that in fig. 8, the tool tube 122 is equipped with two rings 124 attached to the tool tube 122. In further embodiments, the tool tube 122 may be equipped with only one ring or at least 3 rings. The positioning of the ring 124 on the tool tube 122 may vary. As will be further appreciated from fig. 8, the positioning of the tool tube 122 along the body of the endotracheal tube 124 can be adjusted so that the tool tube 122 can be accessed with the cuff 13. A tool such as a stylet 136 may project distally from the tool tube 122, including distally from the distal end 12A of the endotracheal tube 12. The stylet 136 may then guide the endotracheal tube 12 or any other tube medical device 122 into which the tool tube is inserted into the patient for attachment thereto.

Figure 9A provides another embodiment of an endotracheal device, generally 140. In this embodiment, endotracheal tube 12 is combined with a camera head 16, with camera head 16 externally attached to hollow tool tube 142. The tool tube 142 has a distal end 142A and a proximal end 142B. The distal end 16A of the camera head 16 is aligned with the distal end 142A of the tool barrel 142. The proximal end 16B of the camera 16 is aligned with the proximal end 142B of the tool tube 142. As can be seen in the embodiment of FIG. 9A, the distal end 142A of the tool tube 142 extends from the distal end 16A of the camera head 16. When a tool (e.g., any of the tools described in connection with fig. 8) is placed within the tool tube 142, the tool may protrude from the distal end 142A of the tool tube 142. The tool, e.g. a probe, can then be manipulated under continuous visualization by means of the camera 16.

The endotracheal tube 12 is equipped with a cuff 13 and means 14 for inflating the cuff 13, as discussed in detail in connection with fig. 1A. The tool tube 142 is hollow and has an opening at the distal end 142A and an opening at the proximal end 142B. If desired, the tool tube 142 may be capped at the proximal end 142B with a cap 144. The distal end 16A of the camera 16 is aligned directly above the distal end 142A of the tool tube 142. The tool tube 142 is coupled to the endotracheal tube 12 by being inserted under the cuff 13. Thus, the distal end 142A of the tool tube 142 may be distal to the cuff 13. This allows the tool to be inserted distally of cuff 13 under continuous visualization of camera 16 and the desired procedure to be performed.

The tool tube 142, along with the camera head 16, is slidable along the proximal-distal (12B-12A) axis of the endotracheal tube 12. The tool tube 142 with attached camera head 16 may be removed from the patient while maintaining insertion of endotracheal tube 12.

Fig. 9B shows various tools, including but not limited to biopsy forceps 124 or suction tube 130, which may be inserted into tool tube 142. The tool tube 142 may also be used for insertion of a probe (not shown). The probe may be inserted into the tool tube 142 alone or in combination with any other tool. The probe may be located distal to the distal end 12A of the endotracheal tube 12. The probe may then be used to guide placement of endotracheal tube 12 within the patient under continuous visualization by camera 16.

When the tool tube 142 is not in use, the proximal opening of the tool tube 142 may be closed with a cap 144. This allows a closed system to be established for ventilation through the endotracheal tube 12 while the tool tube 142 is still inserted into the patient.

Fig. 10A-10F are other embodiments of an oral airway device 150. As shown in fig. 10A, the device 150 includes a hollow tube 152 having a lumen 154, and the endotracheal tube 12 or any other medical device can be inserted into the hollow tube 152.

The body 152 has a proximal end 152B and a distal end 152A. Tube 152 terminates at a proximal end 152B in a web 156. The sheet 156 is perpendicular to the tube 152 and holds the device 150 in place from sliding into the patient. The tube 152 is slightly curved to follow the curvature of the patient's tongue. In the embodiment of fig. 10A, camera head 16 is coupled to tube 152 by being inserted through channel 158. The channel 158 opens at the proximal side of the sheet 156 and then passes through an opening 160 in the sheet 156. The channel 158 then continues through the wall of the tube body 152 and opens within the lumen 154. Camera head 16 is inserted into lumen 154 through passage 158. In other embodiments, opening 160 is not connected to a channel, rather, a camera is inserted directly through opening 160 and then through an opening in the wall of tube 152 in lumen 154.

The camera head 16 is inserted into the tube 152 through the passageway 158, or in other embodiments, the camera head 16 is inserted directly through the wall of the tube 152 without a passageway. The distal end 16A of the camera head 16 may be aligned with the distal end 152A of the tube 152. The camera head 16 can slide up and down along the tube 152. The camera head 16 may be removed from the tube 152 while the tube 152 remains inserted into the patient.

In the embodiment of fig. 10A, the camera 16 is equipped with a wire 18. In other embodiments, the camera 16 may be wireless. The opening 154 of the tube body 152 may be closed at the proximal end 152B with a vent cap 160. This allows ventilation while the camera 16 is in place and the patient is continuously observed and monitored.

As shown in fig. 10B and 10C, oral airway device 150 may be used to insert endotracheal tube 10 into a patient. In the embodiment of fig. 10B, the passageway 158 enters the tube 152 through the opening 160, as discussed in connection with the embodiment of fig. 10A. In the embodiment of fig. 10C, the channel 158 enters the tube 152 far from the sheet 156. Thus, the sheet 156 in the embodiment of FIG. 10C does not include openings for the channels 158.

Fig. 10D is another embodiment of an oral airway device, generally 170. The device 170 includes a hollow curved tube body 172. The curvature of tube 172 matches the curvature of the patient's tongue for secure placement. The tube 172 has a distal end 172A and a proximal end 172B. Tube 172 terminates at a proximal end 172B in a web 174. The web 174 is perpendicular to the tube 172. The tube 172 is hollow and includes a central lumen 176 through which the endotracheal tube 10 or any other device can be inserted into the patient. Camera head 16 is inserted through opening 178 in plate 174 and aligned along the proximal-distal axis (172B-172A) of tube 172 so that distal end 16A of camera head 16 may be aligned with distal end 172A. The camera head 16 may include a tube 172. The camera 16 may include a wire 18, or the camera 16 may be wireless.

The device 170 further includes a second hollow tube 180 aligned with the tube 172. Balloon 182 is wrapped around tube 172 and tube 180 near distal end 172A. Thus, the two

tubes

172 and 180 are held together by the balloon 182. The distal end 16A of the camera head 16 is inserted under the balloon 182. Thus, the camera 16 may take images at the distal end of the balloon 182. While device 170 remains in place within the patient, camera head 16 may be removed from the patient. The balloon 182 may be inflated with the device 184.

The second tube 180 includes a lumen 182. Tube 180 is attached along the proximal-distal axis of tube 172. The additional tube 180 may be used to position the esophageal blocker 186, and the esophageal blocker 186 may then be placed in the patient's esophagus with direct visualization using the camera 16. The esophageal blocker 186 is equipped with a balloon 188 at the distal end. The balloon 188 may be inflated with the device 190 and seal the upper esophagus of the patient. In addition, the device 170 is equipped with another balloon 182 that is circumferential and wrapped around the

bodies

172 and 180 and is located proximal to the balloon 188. 2 may inflate the balloon 182 using the device 184. The balloon 182 used is used to occlude the upper pharynx. Thus, the device 170 may act as a supraglottic airway, with the endotracheal tube 12 pulling the endotracheal tube 10 proximally back in the device 170 while inflating.

Fig. 10E provides another embodiment of an oral airway device, generally 190. The device 190 includes a curved tube hollow body 192 having a distal end 192A and a proximal end 192B. The tube 192 terminates at a proximal end 192B in a web 194. The web 194 is perpendicular to the tube 192. The camera head 16 is inserted through an opening 196 in the web 194. The camera head 16 then travels along the proximal-distal axis (192B-192A) of the tube body 192 so that the distal end 16A of the camera tube 16 can be aligned with the distal end 192A of the tube body 192.

A stylet 198 or any other tool may be inserted into the central lumen 200 of the tube 192. The distal end 198A of the stylet 198 may protrude distally from the lumen 200. The probe 198 can be used to manipulate the patient's tissue with continuous visualization through the camera 16. Because the camera head 16 can slide along the tube 192, images can be taken at different positions relative to the distal end 192A of the tube 192. With the tube 192 in place, the camera head 16 can be easily removed from the patient.

In the embodiment of fig. 10F, the oral airway device 190 of fig. 10E is assembled with the endotracheal tube 10. In this embodiment, the stylet 198 is inserted under the cuff 13 of the endotracheal tube 12. The endotracheal tube 10 can be inserted with continued viewing from the camera head 16. The insertion may be guided with a probe 198. After insertion is complete, the stylet 198, camera 16 and/or tube 192 may be removed while the endotracheal tube 12 remains inserted into the patient as desired.

Fig. 11A shows another embodiment of an oral airway device, generally 200, with adjustable length for ventilation, continuous visualization and intubation. The device 200 includes a two-part tube 202 having a lumen 203 and having open proximal and distal ends. Because the two-part tube body 202 is made of the outer cylindrical tube wall 204 and the inner cylindrical tube 206, the length of the two-part tube body 202 can be adjusted with the inner cylindrical tube 206 at least partially inserted inside. An inner cylindrical tube 206 may extend from the outer cylindrical tube 204 to increase the length of the two-part tube body 202 as desired.

The inner cylindrical tube 206 may also be retracted inside the outer cylindrical tube 204, thereby reducing the length of the two-part tube body 202 as desired. The diameter of the outer cylindrical tube 204 is larger than the diameter of the inner cylindrical tube 206. Thus, the diameter of lumen 203 of outer cylindrical tube 204 is larger than the diameter of lumen 207 of inner cylindrical tube 206.

The inner cylindrical tube 206 is at least partially inserted inside the larger outer cylindrical tube 204. The inner cylindrical tube 206 may rotate inside the outer cylindrical tube 204. The inner cylindrical tube 206 is also distally movable and may extend distally from the outer cylindrical tube 204, thus lengthening or shortening the length of the body 202 as desired. In some embodiments, the cylindrical tube 206 may be completely detached from the cylindrical tube 204 and removed from the cylindrical tube 204. The tube 204 includes a web 208 near its proximal end. The thin plate 208 is perpendicular to the cylindrical tube 204. After insertion into the patient, the sheet 208 prevents the device 200 from sliding into the patient's mouth.

At least one or both of

cylindrical tubes

204 and 206 are curved to conform to the curvature of the patient's tongue and prevent the tongue from rolling back and obstructing the patient's airway. In alternative embodiments, the

cylindrical tubes

204 and 206 are not curved, but they may be made of plastic or some other resilient material, allowing the tube body 202 to be curved as desired.

The apparatus 200 may include a stylet 210 that may be inserted into the lumen 203 such that a distal end 210A of the stylet 210 may protrude from the lumen 207. In some embodiments, lumen 203 is a complete lumen completely separate from central lumen 203. In other embodiments, lumen 203 is a half-lumen leading to central lumen 203.

Probe 210 may be inserted into and removed from tube 202 at any time, even while tube 202 remains inserted into the patient. In another embodiment, at least one of

cylindrical tubes

204 or 206 can be removed from the patient's mouth while the other cylindrical tube remains inserted into the patient. In some embodiments, the cylindrical tube 206 is removed. In other embodiments, the cylindrical tube 204 is removed.

The apparatus 200 includes a camera 16, and the camera 16 may further include a wire 18. The camera head 16 is inserted into the interior of the cylindrical tube 204 through an opening 212 located near the proximal end of the cylindrical tube 204. Openings 212 are located adjacent to sheet 208. The distal end 16A of the camera 16 may be aligned with the distal end 206A of the cylindrical tube 206 and at a location proximal to the distal end 210A of the probe 210. Thus, probe 210 can be operated under continuous visualization by camera 16.

Fig. 11B shows an embodiment in which the device 200 is further assembled with the endotracheal tube 10 shown in the embodiment of fig. 1A. Those skilled in the art will appreciate that any other endotracheal tube may be used.

Fig. 11C and 11D are enlarged views of the distal portion of the device 200 of fig. 11A. In the embodiment of fig. 11C, the camera 16 is inserted into the wall of the cylindrical tube 206, with the distal end 16A of the camera 16 held at the distal end 206A of the cylindrical tube 206. In the embodiment of fig. 11D, the camera head 16 may be slid distally from the distal end 206A of the cylindrical tube 206. In this embodiment, camera head 16 may protrude outside of distal end 206A. The camera head 16 may be retracted into the wall of the cylindrical tube 206. Fig. 11E provides another embodiment of the device 200. In this embodiment, there is no separate opening for the camera head 16 on the side of the cylindrical tube 204. Instead, the camera 16 is integrated in the wall of the cylindrical tube 206.

Fig. 12A and 12B provide another embodiment of a device, generally 220. The device 220 includes a camera 16 combined with a stylet 222, the stylet 222 providing the skeleton and shape for the otherwise flexible camera 16. As shown in the embodiment in fig. 12B, the stylet 222 can be curved. The camera 16 may include a wire 18. The camera head 16 is also coupled to a hollow tube 224. Various tools, such as a probe 226, may be inserted through the tube 224. Since the tube 224 has an open distal end 224A, a stylet 226 may project distally from the tool tube 224 to the distal end 16A of the camera head 16. Thus, probe 226 can be manipulated under continuous visualization by camera 16. Device 220 may be used in conjunction with any other medical device. Device 220 may be used to guide the placement of a medical device, such as an endotracheal tube. The placement of the medical device may be guided by probe 226, which may be used to remove tissue from the medical device channel with continuous visualization by camera 16. The stylet 200 can be made of a material, such as plastic. It may be bent into a specific shape as desired.

Fig. 13 provides another embodiment of an oral airway device, generally 230. It comprises two hollow tubes. The first hollow tube 232 is inserted inside the second hollow tube 234. The assembly of the two

hollow tubes

232 and 234 is flexible such that the first hollow tube 232 can be rotated inside the second hollow tube 234. The second hollow tube 234 may also rotate about the first hollow tube 232.

At least the second hollow tube 234 or both

hollow tubes

232 and 234 are curved such that the oral airway device 230 follows the contours of the top of the patient's mouth. After insertion into the patient, oral airway device 230 flexes and rests over the patient's tongue, thus preventing the patient's tongue from obstructing the patient's airway.

The length of the first hollow tube 232 is longer than the length of the second hollow tube 234. The first hollow tube 232 can slide in and out of the second hollow tube 234 along the proximal-distal axis AB. The distal end 232A of the first hollow tube 232 may extend outside of the second hollow tube 234 and retract back inside of the second hollow tube 234. Thus, the length of the device 230 may be increased or decreased, or may be adjusted as desired. Such adjustable dimensions of the oral airway 230 provide significant technical advantages and complications may be avoided, such as failing to hold the tongue in place if the oral airway is too short, or inadvertently pressing the tongue back into the airway if the oral airway is too long.

After placement in the patient, the first hollow tube 232 may be removed from the patient while the second hollow tube 234 remains in place. Alternatively, the second hollow tube 234 may remain within the patient while the first hollow tube 232 is removed from the patient. This allows either of the two

tubes

232 and 234 to be easily cleaned and replaced if desired.

In the embodiment of fig. 13, the camera head 16 is externally attached to the second hollow tube 234. The distal end 16A of the camera head 16 is in close proximity to the distal end 234A of the second hollow tube 234. The second hollow tubes 234 terminate in webs 236. The sheet 236 is oval shaped with no sharp edges. The purpose of the flap 236 is to remain around the patient's lips when the hollow tube 234 is inserted into the patient. Thus, after placement of device 230, sheet 236 prevents device 230 from sliding into the patient's pharynx. The thin plate 236 has two

openings

238 and 240.

An opening 238 is centrally located in the sheet 236 for insertion of the first hollow tube 232 into the second hollow tube 234. The first hollow tube 232 is inserted into the second hollow tube 234 through the opening 238 such that the proximal end 232B is proximate the sheet 236. The proximal end 232B remains outside the patient.

Opening 240 is positioned on web 236 such that distal end 16A of camera head 16 is inserted through opening 240. The distal end 16A of the camera head 16 is then aligned with the distal end 234A of the second hollow tube 234.

The first hollow tube 232 may be used in conjunction with a probe 242. The first hollow tube 232 includes a central lumen 244. The wall of the first hollow tube 232 may include an additional tool lumen 246 for insertion of a stylet 242 or other tool. It will be readily appreciated that in some embodiments, the tool lumen 246 may be a complete lumen completely separate from the central lumen 244. In other embodiments, the tool lumen 246 may be a half lumen connected to the central lumen 244. In at least some other embodiments, the tube 232 does not include a tool lumen 246, but rather a tool is inserted into the central lumen 244.

The distal end 242A of probe 242 protrudes from the distal end 232A of first hollow tube 232. Proximal end 242B of probe 242 projects proximally of oral airway device 230 and will remain outside the patient's body for ease of handling.

In the embodiment of fig. 13, the first hollow tube 232 terminates at the distal end 232A in a tapered tongue 250. The first hollow tube 232 is rotatable within the second hollow tube 234 such that the distal end 242A of the probe 242 is in direct line of sight with the camera head 16. The probe 242 is positioned over the tapered tongue 250 of the first hollow tube 232.

The first and second

hollow tubes

232, 234 may be moved independently of one another, including being rotated relative to one another.

Referring to fig. 14A, an oral airway device, generally 260, is provided that includes a curved tube 262 having a central lumen 264, which lumen 264 may be used to insert various devices, such as an endotracheal tube (not shown). Thus, the curved tube body 262 is hollow. Device 260 may be used to prevent the tongue from covering the epiglottis. Thus, the device 260 may be used to open and maintain the airway of a patient open. The curved tube 262 is curved in a manner that conforms the curved tube 262 to the shape of the top of the patient's mouth. The curved tube 262 will rest on the patient's tongue and prevent the tongue from obstructing the patient's airway.

The cuff 266 is wrapped around the curved tube 262 in figure 14A. A handle 268 is attached to the cuff 266. The camera head 16 with the electrical wires 18 runs externally along a curved tube 262. The distal end 16A of the camera head 16 is aligned with the distal end 262A of the curved tube 262. At the proximal end 262B, the bent tube body 262 terminates in a web 270, the web 270 lying horizontally on the vertically oriented proximal end 262B. The sheet 270 has a central opening to the internal cavity 264. The plate 270 has another opening 272 for insertion of the camera head 16.

As shown in fig. 14B, the handle 268 can be pushed distally such that the cuff 266 moves along the proximal-distal axis AB of the curved tube body 262. The cuff 266 may be a tube or balloon of soft material that can be inflated to occlude the upper esophagus. Importantly, cuff 266 is wrapped over camera 16. Thus, as the cuff 266 moves distally along the curved tube body 262, the camera 16 can still obtain images distal of the cuff 262.

Fig. 15A provides another embodiment of an oral airway device equipped with a camera, generally 280. Oral airway device 280 includes a hollow tube 282 having a central lumen 284. The tube 282 is a curved wall. The curvature of the tube 282 follows the curvature of the patient's tongue so that the device 280 can be placed on the patient's tongue and prevent the tongue from rolling up.

The tube 282 has a distal end 282A and a proximal end 282B. An inflatable cuff 286 is wrapped around the tube 282 near the distal end 282A. After placement of oral airway device 280 in the patient, cuff 286 may be inflated with device 288. The tube 282 terminates at a proximal end 282B with a web 290. The sheet 290 is perpendicular to the tube 282 and remains outside the patient's body. Plate 290 prevents device 280 from sliding into the patient. The tube 282 with the sheet 290 includes a central lumen 284. A hollow tube 292 is located within the central lumen 284. The hollow tube 292 extends along the wall of the tube 282 from its distal end 282B to its proximal end 282A. The hollow tube 292 is glued or otherwise attached to the wall of the tube 282. The camera 294 may be inserted into the hollow tube 292.

Next to the hollow tube 292 is a slit-wall tube 296 inside the central lumen 284. The slit-wall tube 296 is glued or otherwise attached along the wall of the tube body 282 such that the distal end 296A of the slit-wall tube 296 is aligned with the distal end 282A of the tube body 282. The distal end 296A of the slit-wall tube 296 is immediately adjacent to the distal end of the tube 292. The slit-wall tube 296 may contain a probe 298, the probe 298 may be inserted into the slit-wall tube 296 through the proximal end 296B because the camera 294 is proximate to the probe 298 when the probe 298 is inserted into the slit-wall tube 296, the probe 298 may be used to guide the insertion of a medical device located in the central lumen 284 under controversial visualization. In addition to inserting the probe 298 into the slit-wall tube 296, other tools may be inserted into the slit-wall tube 296. The probe 298 may be removed from the slit-wall tube 296 and reinserted as desired.

Although the embodiment of fig. 15A provides a slit wall tool tube for an oral airway device, it will be appreciated that slit wall tool tubes may be used in other embodiments of the present disclosure, including tool tubes in the endotracheal devices of fig. 8, 9A and 9B, the oral airway devices of fig. 11A, 11B, 11C, 11D and 11E, and any other device in which a tool tube is used to deliver a probe and/or any other tool.

Another embodiment of an oral airway device, generally 300, is shown in fig. 15B. In this embodiment, the oral airway device 300 includes a hollow tube 302. The hollow tubular body 302 includes a central lumen 304. The hollow tube 302 is a curved wall that follows the curvature of the patient's tongue. The hollow tubular body 302 includes a distal end 302A and a proximal end 302B. The cuff 306 is wrapped around the tubular body 302 near the distal end 302A.

The cuff 306 may be inflated using a device 308 located proximal to the proximal end 302B of the tube 302. The tube 302 terminates at a proximal end 302B with a web 310. The sheet 310 is perpendicular to the tube 302 and remains outside the patient after the device 300 is inserted into the patient. The sheet 310 prevents the device 300 from sliding into the patient. The walls of the tube 302 together with the sheet 310 form a central lumen 304.

The hollow tube 312 extends along the tube 302 externally along the proximal-distal (302A-302B) axis of the tube 302. The distal end 312A of the tube 312 is aligned with the distal end 302A. A tube 312 extends below the cuff 306. Thus, the cuff 306 is wrapped around the tube 312 and the tubular body 302. The cuff 306 holds the tube 312 to the tube body 302 at the distal end 302A. The proximal end 312B of tube 312 is inserted through opening 314 in sheet 310. The camera 316 is inserted through the proximal end 312B of the tube 312. Since the distal end 312A is not sealed, the camera 316 may protrude distally from the tube 312. If the camera 316 is no longer needed, it can be removed from the tube 312.

A slit-wall tube 318 extends along the body 302. The slits 320 of the slit-wall tube 318 are aligned with the lumen 304 of the body 302. Thus, the lumen 304 of the body 302 and the slit-wall tube 318 may be connected by the slit 320. The probe 322 may be inserted into the slit-wall tube 318. The cuff 306 is wrapped around the slit-wall tube 318 and the tubular body 302. The cuff 306 holds the slit-wall tube 318 in place on the distal end 302A of the tube body 302. The proximal end 318B of the slit-wall tube 318 is inserted through the opening 324 of the sheet 310. Although only the probe 322 is shown in FIG. 15B, it should be understood that the slit-wall tube 318 may be used with any other tool, such as a biopsy forceps or suction tube. The distal end 318A of the slit-wall tube 318 is in close proximity to the distal end 312A of the tube 312. Thus, the probe 322 may be operated under continuous visualization by the camera 316.

It will be appreciated that although the embodiment of fig. 15A and 15B provides a slit-wall tube in connection with an oral airway device, the slit-wall tube may be used in any other device shown in the present application. The slit wall pipe may be used in any apparatus in which a tool pipe is useful, in addition to tool pipes.

Fig. 16A shows an embodiment of a supraglottic airway device, generally 330. The device 330 includes a hollow tube 332, with the wall 334 of the hollow tube 332 forming a central lumen 336. At the distal end 332A, the tubular body 332 terminates with a flexible cuff 338. The cuff 338 cannot be inflated. In other embodiments (not shown), the device 330 may include an inflatable cuff instead of the cuff 338. The wall 334 of the body 332 includes a lumen 340, the lumen 340 extending from the proximal end 332B of the body 332 to the distal end 332A of the body 332. A camera 342 may be inserted through the lumen 340 and provide images to the distal end of the device 330. Lumen 340 is unsealed. Thus, camera 342 may protrude distally from lumen 340. The wall 334 also includes a half-lumen 344, the half-lumen 344 opening into the central lumen 336 through a slit 346. The half lumen 344 begins at the proximal end 332B of the body 332. The half lumen 344 extends all the way to the distal end 332A of the body 332. The probe 348 may be inserted through the half lumen 334. When inserted into the half-lumen 34, the probe 348 may protrude distally from the device 330. Half lumen 334 is in close proximity to lumen 340.

Accordingly, probe 348 may be operated under continuous visualization from camera 342. This allows the placement device 330 to be guided under continuous visualization from the camera 342 through the probe 348. As probe 348 may also be brought into camera 342. Because stylet 348 can also be advanced into main lumen 336 through slit 346, stylet 348 can also assist in guiding the placement of any other device, such as an endotracheal tube, when inserted into central lumen 336.

Figure 16B shows an endotracheal tube 350 inserted into the device 330. Any endotracheal tube shown in the present application or known in the art may be used in assembly with the device 330.

Another embodiment of a device, generally 360, is shown in fig. 17A. The device 360 may be characterized as a truncated supraglottic device in that the device 360 has a truncated tube 362, the truncated tube 362 terminating at a distal end 362A of the truncated tube 362 with a soft cuff 364. The wall 366 of the truncated tube 362 includes: a lumen 368. Lumen 368 extends proximally from body 362 as tube 370. The length of tube 370 is such that proximal end 370B may extend outside of the patient's body while the truncated tube body 362 is fully inserted into the patient. Camera 372 is inserted into tube 370 through proximal end 370B of tube 370. A camera 372 may protrude distally from the lumen 368 and take images distally of the device 360. The device 360 is equipped with a handle 374 extending along a tube 370. Handle 374 includes at least one half ring 376, which when coupled with device 360, the at least one half ring 376 is used to hold an endotracheal tube or any other tube device in place. Although in the embodiment of fig. 17A, the support is a half-ring, other options may include a ring, including a ring with snap rings.

In addition to lumen 368, wall 366 includes a half lumen 378 that opens through a slit 380 to a main lumen 382 of truncated tube 362. Like the lumen 368 extending through the tube 370 from about the truncated body 362, the lumen half 378 also extends proximally through the slit-wall tube 382. After the device 360 is inserted into the patient, the proximal end 382B of the slit-wall tube 382 remains outside the patient. A stylet 384 is inserted through the proximal end 382B of the slit-wall tube 382. Stylet 384 may protrude distally from half lumen 378. Half lumen 378 is in close proximity to lumen 368 so that probe 384 can be monitored by camera 372. Stylet 384 guides the placement of device 360 and any other tube devices, such as endotracheal tubes, with continuous visualization by camera 372.

Figure 17B shows an endotracheal tube 386 in combination with apparatus 360. Endotracheal tube 386 is retained on device 360 by half ring 376. An endotracheal tube 386 is inserted into the lumen 382 of the truncated tube 362. Distal end 386A of endotracheal tube 386 can protrude distally from device 360. Placement of the device 360 may be guided by manipulation of the handle 374. Probe 384 and camera 372 are not shown in fig. 17B, but would be positioned as shown in connection with fig. 17A.

Referring to fig. 18A, a medical glove equipped with a camera, generally 390, is provided. The medical glove 390 has a dorsal side 392 that covers the dorsal side of a human hand. Also typical for medical gloves, the medical glove 390 includes five fingers-for each finger of a human hand. The physician may wear glove 390 on his/her hand. In the embodiment of fig. 18A, a right hand glove is shown. Those skilled in the art will appreciate that in alternative embodiments, the left-hand glove may also be equipped with a camera.

In the embodiment of fig. 18A, camera 394 includes a distal end 394A and a proximal end 394B. The distal end 394A of the camera 394 is aligned over the tip of the index finger 396. This allows continuous visualization through the camera 394 at the distal end of the medical glove 390. The camera 394 is then sealed or otherwise attached to the back side 392 of the glove 392. The proximal end 394B of the camera 394 extends over the gloved hand and may be connected by a wire to a computer or any other device. In some embodiments, camera 394 may transmit the image wirelessly.

It will be appreciated that in other embodiments, the camera 394 may be positioned on the middle finger 398 or any other finger of the glove 390. The camera 394 may be attached to any portion of the medical glove, any of the fingers of the medical glove, including the thumb 400, hand, and/or wrist 402. The glove 390 may further be equipped with a tool tube (not shown) that may be used to insert a tool such as a stylet. The camera 394 may be positioned on the palm of the hand in addition to being placed on the back side of the glove.

Another embodiment of a glove 390 is shown in fig. 18B, wherein the glove 390 is equipped with a set of at least three rings 404 s. In other embodiments, the number of rings may vary from 1 to 20. At least some of the rings 404 are located on at least one finger. In the drawing of FIG. 18B, the ring 404 is positioned above the index finger. Camera 394 may be securely attached to glove 390 by ring 404. When visualization is no longer needed, camera 394 may be removed from glove 390. If additional rings 404 are positioned over middle finger 398 and/or any other fingers, camera 394 can be easily moved between the different fingers as desired.

Referring to fig. 19A, a camera 406 is provided that includes two

brackets

408 and 410 for attaching the camera 406 to an endotracheal tube 412, as shown in fig. 19B. The camera 406 has a distal end 406A and a proximal end 406B. Images are collected at the distal end.

The

brackets

408 and 410 are attached to the camera 394 by an adhesive. In some embodiments, two brackets are used. In other embodiments, one to ten brackets may be used. The bracket 408 is circular and has a slit 409. The diameter of the stent 408 is designed such that the endotracheal tube 412 can be pushed into the stent 408 through the slit 409. The stent 410 is also circular and includes a slot 411 through which an endotracheal tube 412 can fit. Thus, the camera 406 may be secured to the body of the endotracheal tube 412 by the

brackets

408 and 410 such that the distal end 406A of the camera 406 may be moved along the endotracheal tube 412 toward or away from the distal end 412A of the endotracheal tube 412. Although in embodiments 19A and 19B, the

brackets

408 and 410 are circular with slits, other embodiments may include those in which at least one bracket is a loop and/or a loop of a buckle. The camera 406 may be incorporated not only with an endotracheal tube, but with any other device including a tube (including an oral airway).

Referring to fig. 20, a vented cover 414 having a camera 416 is provided. The vent cap 414 may be positioned over the supraglottic airway 418 or the endotracheal tube 420 or any other device having a tube body. The camera head 416 may be inserted through an opening 422 in the cap 414 such that a distal end 416A of the camera head 416 may protrude distally from the

device

418 or 420 or any other tube device into which the camera head 416 is inserted. Combining the vent cap 414 with the

device

418 or 420 allows a closed system to be established and the patient to be vented. This may be achieved under continuous visualization by the camera 416. A proximal end 416B of camera head 416 protrudes proximally of vent cap 414. The proximal end 416B remains outside the patient. The proximal end 416B may be connected to a computer and/or monitor. Camera head 416 may be removed from the patient's body through opening 422 while vent cap 414 remains in place within the patient's body. The vent cap 414 may be used with any supraglottic device, including those shown in the present application. The vent cap 414 may be used in conjunction with any endotracheal tube, including any of the endotracheal tubes shown in the present application.

Referring to fig. 21, there is shown a trocar equipped with a camera, generally 450. The trocar 450 has a hollow tube 452, which tube 452 may be flexible or rigid, having a distal end 452A and a proximal end 452B. A sharp piercing awl 454 protrudes from the distal end 452A of the hollow tube 452, the wall of the hollow tube 452 including a lumen or semi-lumen through which a camera 456 is inserted.

The distal end 456A of the camera 456 is located near the distal end 452A of the hollow tube 452. The proximal end 456B of camera 456 remains outside the patient's body. Camera 456 may provide visualization of stylus 454.

The device 450 may be used during laparoscopic surgery to create an opening in a patient with a stylus 454 under continuous visualization by a camera 456. After an opening is formed in the body, the stylus 454 may be retracted from the hollow body 452. Various instruments, i.e., laparoscopes, required to perform the operation can be inserted through the hollow tube 452. It should be appreciated that the camera 456 may be incorporated with any laparoscopic trocar, including robotic trocars.

While certain medical devices have been illustrated above, it will be apparent to those skilled in the art that the present invention also includes embodiments having various common modifications.

Claims

1. A medical intubation device, comprising: a camera head, which is combined with an additional device, wherein the additional device comprises an endotracheal tube, an oral cavity airway tube, a tracheostomy tube, an inhalation tube, a tubeless intubation device, an supraglottic oral cavity airway tube, a truncated supraglottic oral cavity airway tube, a tool tube, a trocar, a vent cover, a medical detection glove and/or a stylet; the camera has a distal end and a proximal end, and the attachment has a distal end and a proximal end, the camera distal end being adjacent the attachment distal end.

2. The medical intubation device according to claim 1, wherein the camera is mounted on a tube and is integrated with the add-on device by placing the add-on device in the tube, and wherein the position of the camera on the add-on medical device is adjustable by sliding the tube along a proximal-distal axis of the add-on device.

3. The medical intubation device according to claim 1, wherein said camera head is mounted on at least one ring, optionally including a snap ring, and said attachment includes a tube, and said camera head is coupled to said attachment by said ring secured around said tube.

4. The medical intubation device according to claim 1, wherein the add-on device includes a cuff, and wherein the camera is coupled to the add-on device by being placed under the cuff such that a distal end of the camera is located distal to the cuff.

5. The medical intubation device according to claim 1, wherein the camera is mounted on the tool tube and/or the stylet.

6. The medical intubation device according to claim 1, wherein the camera is mounted on the tool tube and/or the stylet, and a stylet is disposed in the tool tube, the stylet having a proximal end and a distal end, and the distal end of the stylet protrudes from the distal end of the tool tube, and the stylet protrudes from the distal end to the distal end of the camera.

7. The medical device of claim 6, wherein the tool tube is a slit-wall tube.

8. The medical intubation device according to claim 1, wherein said additional device is said endotracheal tube and an inflatable cuff wrapped over said endotracheal tube proximate a distal end of said endotracheal tube, said camera head being sealed along an exterior of a proximal-distal axis of said endotracheal tube.

9. The medical intubation device according to claim 1, wherein said add-on device is an endotracheal tube with an inflatable cuff wrapped over said endotracheal tube proximate a distal end thereof, said camera head being sealed along an exterior of a proximal-distal axis of said endotracheal tube.

10. The medical intubation device according to claim 1, wherein the add-on device is an endotracheal tube with an inflatable cuff wrapped over the endotracheal tube and the camera head is proximal to a distal end of the endotracheal tube, and a distal end of the camera head collects images of a distal end of the cuff.

11. The medical intubation device according to claim 1, wherein said add-on device is an endotracheal tube with an inflatable cuff wrapped around said endotracheal tube and said camera head is located near a distal end of said endotracheal tube, and said endotracheal tube has a sleeve near a proximal end of said endotracheal tube and said camera head is inserted into said sleeve.

12. The medical intubation device according to claim 1, wherein the add-on device is a tracheostomy tube including a tube with a sheet and an inflatable cuff wrapped around the tube near a distal end of the tube, and wherein the camera is coupled to the exterior of the tube by being inserted into an opening of the sheet and placed under the inflatable cuff.

13. The medical intubation device according to claim 1, wherein said add-on device is said endotracheal tube externally coupled to a tool tube, said tool tube optionally including a cap, and said endotracheal tube being secured thereto by at least one ring, said camera head being slid into said tool tube, and at least one of the following tools being selectively insertable into said tool tube: biopsy forceps, esophageal stethoscopes, sleeves, suction tubes, gastric tubes, stylets, and/or probes.

14. The medical intubation device according to claim 1, wherein said add-on device is said endotracheal tube, wherein said endotracheal tube is externally associated with a tool tube, said tool tube optionally including a cap, and said endotracheal tube is secured to said endotracheal tube by a cuff wrapped around said tool tube and said endotracheal tube, said camera head being slid into said tool tube, and wherein at least one of the following tools is selectively insertable into the tool tube: biopsy forceps, esophageal stethoscopes, sleeves, suction tubes, gastric tubes, stylets, and/or probes.

15. The medical intubation device according to claim 1, wherein said attachment means is said oral airway tube comprising a curved tube having a proximal end and a distal end, said tube having a lumen and a sheet at the proximal end of said curved tube, and said camera is coupled to said tube by insertion through an opening in said sheet and then through an opening in the wall of said curved tube, the distal end of said camera being inside said lumen and near the distal end of said curved tube.

16. The medical intubation device according to claim 1, wherein said add-on device is said oral airway tube comprising a hollow curved tube body having a proximal end and a distal end, said hollow tube body having a lumen and a sheet at the proximal end of said curved tube body, and said camera head is coupled to the tube body by being inserted through an opening in said sheet and positioned along the exterior of the hollow curved tube body, said add-on device further comprising another hollow tube body aligned with said hollow curved tube body, and a balloon surrounding said hollow curved tube body, said another hollow tube body and said camera head.

17. The medical intubation device according to claim 1, wherein said add-on device is said oral airway device, comprising a two-part tube body made of an outer cylindrical tube wall and an inner cylindrical tube, at least a portion of said inner cylindrical tube being insertable into said outer cylindrical tube, said inner cylindrical tube wall being extendable, said camera head being inserted into said two-part tube body through an opening located near a proximal end of said tube body to engage said oral airway device, said add-on device further optionally comprising a probe.

18. The medical intubation device according to claim 1, wherein said attachment means is said oral airway device, which comprises two hollow tubes, a first hollow tube and a second hollow tube, said first hollow tube being partially inserted into said second hollow tube, said first hollow tube having a length longer than that of said second hollow tube, said first hollow tube being insertable into and removable from said second hollow tube, said first hollow tube having a tapered tab at a distal end, said second hollow tube having a sheet at a proximal end, said camera head being inserted through an opening in said sheet and engaging said attachment means by being placed along the exterior of said second hollow tube, said oral airway device comprising a tool lumen.

19. The medical intubation device according to claim 1, wherein said add-on device is said oral airway device, including a curved tube with a central lumen and a sheet at a proximal end of said curved tube, said cuff being wrapped around said curved tube, said cuff having a handle attached thereto, said cuff being movable by said handle from said proximal end of said curved tube to said distal end of said curved tube, said camera being engaged with said oral airway device through an opening inserted into said sheet, wherein said sheet is placed along the exterior of said curved tube and said cuff is wrapped around said camera such that said camera distal end is located distal to said cuff.

20. The medical intubation device according to claim 1, wherein the add-on device is the oral airway device, which comprises a curved tube body having a central lumen, wherein two tubes are inserted into the central lumen, a first hollow tube and a second hollow tube with slit walls, wherein the first and second hollow tubes are each mounted to the wall of the oral airway device, and wherein the distal end of the first hollow tube and the distal end of the second hollow tube are near the distal end of the curved tube body, wherein a camera may be inserted in the first hollow tube, and wherein a probe and/or a medical instrument may be inserted in the second hollow tube.

21. The medical intubation device according to claim 20, wherein a cuff is wrapped around the curved tube body near the distal end of the curved tube body.

22. The medical intubation device according to claim 1, wherein the attachment means is the supraglottic oral airway comprising a tube with a central lumen, a flexible cuff surrounding the distal periphery of the tube, the wall of the tube comprising a first lumen and a second lumen with a slit, the camera being insertable into the first lumen, a probe being insertable into the second lumen, and the slit connecting the second lumen and the central lumen of the tube.

23. The medical intubation device according to claim 22, wherein said tube is truncated and said device includes a handle with a stent, a first tube connected to said first lumen and a second tube with slit walls connected to said second lumen through a slit.

24. A method of intubating a patient, the method comprising inserting the medical device of claim 1 by guiding the insert with a stylet under continuous visualization by said camera.